Effect of Preemptive Ibuprofen and Dexketoprofen on Postoperative Pain After Septorhinoplasty

Year 2022, Volume: 39 Issue: 4, 1083 - 1087, 29.10.2022

Özgür Kemal , Ayşe Çeçen , Esra Kavaz , Mustafa Taştan , Yavuz Çeçen , Ersin Köksal

Abstract

Objective: Postoperative comfort is as significant as the postoperative results in patients who underwent septorhinoplasty. Intravenous NSAIDs are playing an increasingly large role in analgesia, antiinflammation and antipyresis in the hospitalized setting. The aim of this study is to assess the preemptive analgesic effect of intravenous ibuprofen and dexketoprofen on postoperative pain in patients undergoing septorhinoplasty.
Methods: This study was performed with 76 patients who undergoing open septorhinoplasty between 2016 and 2017. The patients were separated into two groups; Group D (n=46) received preemptive intravenous dexketoprofen (50 mg), and Group I (n=30) received preemptive intravenous ibuprofen (800 mg). Pain was assessed at 30th min and 1st, 2nd, 6th,12th and 24th hrs postoperatively using a visual analogue scale (VAS). There was no statistically significant difference between the groups for sex, age, weight, height, ASA class, anesthesia and surgery duration.
Results: VAS scores gradually decreased between 30 minutes and 24 hours in both groups and this decrease was statistically significant in both groups (Group D; p <0.001, Group I; p <0.001). The mean VAS scores in the same periods were lower in Group I at all times, but the difference was not statistically significant (p>0.05).
Conclusion: This study had indicated that both ibuprofen and dexketoprofen had similar analgesic efficacy. Clinicians can use these two drugs interchangeably by comparing side effects and costs.

Keywords

Analgesia, Dexketoprofen, Ibuprofen, Pain, Rhinoplasty

Septorinoplasti Sonrası Preemptif İbuprofen ve Deksketoprofen'in Postoperatif Ağrı Üzerine Etkisi

Abstract

Amaç: Septorinoplasti yapılan hastalarda ameliyat sonrası estetik sonuçlar kadar ameliyat sonrası konfor da önemlidir. İntravenöz NSAID'ler, hastane ortamında analjezi, antiinflamasyon ve antipirezde giderek daha büyük bir rol oynamaktadır. Bu çalışmanın amacı septorinoplasti uygulanan hastalarda intravenöz ibuprofen ve deksketoprofen'in postoperatif ağrı üzerine preempitif analjezik etkisini değerlendirmektir.
Gereç ve Yöntemler:
Bu çalışmaya 2016-2017 yılları arasında açık septorinoplasti uygulanan 76 hasta dahil edildi. Hastalar; Grup D (n=46) preempitif intravenöz deksketoprofen (50 mg) tedavisi alan ve Grup I (n=30) preempitif intravenöz ibuprofen tedavisi alan (800 mg) olarak iki gruba ayrıldı. Ağrı postoperatif 30. dk ve 1., 2., 6., 12. ve 24. saatlerde görsel analog skala (VAS) ile değerlendirildi. Gruplar arasında yaş, cinsiyet, kilo, boy, ASA sınıfı, anestezi ve ameliyat süresi açısından istatistiksel olarak anlamlı fark yoktu.
Bulgular:
VAS skorları her iki grupta da 30 dakika ile 24 saat arasında kademeli olarak azaldı ve bu azalma her iki grupta da istatistiksel olarak anlamlıydı (Grup D; p <0.001, Grup I; p <0.001). Aynı dönemlerdeki ortalama VAS skorları Grup I' de her zaman daha düşüktü ancak aradaki fark istatistiksel olarak anlamlı değildi (p>0.05).
Sonuç:
Bu çalışma, hem ibuprofen hem de deksketoprofen'in benzer analjezik etkinliğe sahip olduğunu göstermiştir. Klinisyenler, yan etkileri ve maliyetleri karşılaştırarak bu iki ilacı birbirinin yerine kullanabilir.

Keywords

Analjezi, Deksketoprofen, İbuprofen, Ağrı, Rinoplasti

References

• 1. Carr DB, Goudas LC. Acute pain. Lancet. 1999;353(9169):2051-8.
• 2. Savoia G, Alampi D, Amantea B, Ambrosio F, Arcioni R, Berti M, et al. Postoperative pain treatment SIAARTI Recommendations 2010. Short version. Minerva Anestesiol. 2010;76(8):657-67.
• 3. Celik EC, Kara D, Koc E, Yayik AM. The comparison of single-dose preemptive intravenous ibuprofen and paracetamol on postoperative pain scores and opioid consumption after open septorhinoplasty: a randomized controlled study. Eur Arch Otorhinolaryngol. 2018;275(9):2259-63.
• 4. Wittekindt D, Wittekindt C, Schneider G, Meissner W, Guntinas-Lichius O. Postoperative pain assessment after septorhinoplasty. Eur Arch Otorhinolaryngol. 2012;269(6):1613-21.
• 5. Gozeler MS, Sakat MS, Kilic K, Ozmen O, Can A, Ince I. Does a single-dose preemptive intravenous ibuprofen have an effect on postoperative pain relief after septorhinoplasty? Am J Otolaryngol. 2018;39(6):726-30.
• 6. Southworth S, Peters J, Rock A, Pavliv L. A multicenter, randomized, double-blind, placebo-controlled trial of intravenous ibuprofen 400 and 800 mg every 6 hours in the management of postoperative pain. Clin Ther. 2009;31(9):1922-35.
• 7. Nguyen BK, Yuhan BT, Folbe E, Eloy JA, Zuliani GF, Hsueh WD, et al. Perioperative Analgesia for Patients Undergoing Septoplasty and Rhinoplasty: An Evidence-Based Review. Laryngoscope. 2019;129(6):E200-E12.
• 8. Aydil U, Yilmaz M, Akyildiz I, Bayazit Y, Keseroglu K, Ceylan A. Pain and safety in otorhinolaryngologic procedures under local anesthesia. J Otolaryngol Head Neck Surg. 2008;37(6):851-5.
• 9. Mutlu V, Ince I. Preemptive intravenous ibuprofen application reduces pain and opioid consumption following thyroid surgery. Am J Otolaryngol. 2019;40(1):70-3.
• 10. Tuncer S, Reisli R, Kececioglu M, Erol A. [The effects of intravenous dexketoprofen on postoperative analgesia and morphine consumption in patients undergoing abdominal hysterectomy]. Agri. 2010;22(3):98-102.
• 11. Ozer AB, Erhan OL, Keles E, Demirel I, Bestas A, Gunduz G. Comparison of the effects of preoperative and intraoperative intravenous application of dexketoprofen on postoperative analgesia in septorhinoplasty patients: randomised double blind clinical trial. Eur Rev Med Pharmacol Sci. 2012;16(13):1828-33.
• 12. Uribe AA, Arbona FL, Flanigan DC, Kaeding CC, Palettas M, Bergese SD. Comparing the Efficacy of IV Ibuprofen and Ketorolac in the Management of Postoperative Pain Following Arthroscopic Knee Surgery. A Randomized Double-Blind Active Comparator Pilot Study. Front Surg. 2018;5:59.
• 13. Keskioglu I, Aktay Inal M, Ozlu O. [The effectiveness of preemptive analgesic techniques on postoperative analgesia in patients undergoing open septorhinoplasty]. Agri. 2016;28(3):135-42.
• 14. Jimenez-Martinez E, Gasco-Garcia C, Arrieta-Blanco JJ, Gomez del Torno J, Bartolome Villar B. Study of the analgesic efficacy of Dexketoprofen Trometamol 25mg. vs. Ibuprofen 600mg. after their administration in patients subjected to oral surgery. Med Oral. 2004;9(2):143-8, 38-43.
• 15. Kupeli I, Gulnahar Y. Impact of Pre-Emptive Intravenous Ibuprofen on Perioperative Analgesia in Patients Undergoing Third Molar Extraction: A Randomised Controlled Study. Turk J Anaesthesiol Reanim. 2019;47(6):480-4.
• 16. Sener M, Yilmazer C, Yilmaz I, Caliskan E, Donmez A, Arslan G. Patient-controlled analgesia with lornoxicam vs. dipyrone for acute postoperative pain relief after septorhinoplasty: a prospective, randomized, double-blind, placebo-controlled study. Eur J Anaesthesiol. 2008;25(3):177-82.